Individual provider Active NPI

Kyle Christopher Zink, LICDC, LPC

  • Mental Health Counselor
  • Dayton, OH
National Provider Identifier
1225552078
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.240717 Issued in OH
Practice address
1 Elizabeth PL
Dayton, OH 45417-3445
Phone
(937) 813-1737
NPI assigned
Aug 2, 2017
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCII.161323 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.162094 OH
Mental Health Counselor 101YM0800X E.240717 OH Primary
Professional Counselor 101YP2500X 2204598 OH

Addresses

Primary practice location

1 Elizabeth PL
Dayton, OH 45417-3445

Mailing address

2471 Brown Bark Dr
Beavercreek, OH 45431-2618
Phone (937) 426-1421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCDCII.161323OHMDAddiction (Substance Use Disorder) Counselor
LICDC.162094OHMDAddiction (Substance Use Disorder) Counselor
E.240717OHMDMental Health Counselor
2204598OHMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1225552078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2471 BROWN BARK DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312618",
            "telephone_number": "937-426-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-813-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINK",
        "first_name": "KYLE",
        "middle_name": "CHRISTOPHER",
        "credential": "LICDC, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCII.161323",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162094",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.240717",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "2204598",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.